Adults: 30 to 90 mg P.O. three to four times daily (tablets), or 60 to 120 mg P.O. b.i.d. (sustained-release), or 180 to 240 mg P.O. once daily (extended-release), adjusted after 14 days as needed, up to a total daily dosage of 360 mg. Or 0.25 mg/kg by I.V. bolus over 2 minutes; if response is inadequate after 15 minutes, may give 0.35 mg/kg over 2 minutes; may follow with continuous I.V. infusion at 10 mg/hour (at a range of 5 to 15 mg/hour) for up to 24 hours.

Administration

• When giving I.V., dilute in dextrose 5% in water or normal saline solution.• Give I.V. bolus dose over 2 minutes; a second bolus may be given after 15 minutes.• Administer continuous I.V. infusion at a rate of 5 to 15 mg/hour.

Patient monitoring

☞ Monitor for signs and symptoms of heart failure and worsening arrhythmias.• Supervise patient during ambulation.

Patient teaching

• Instruct patient to swallow extended-release capsules whole and not to crush or chew them.• Advise patient to change position slowly to minimize light-headedness and dizziness.• Caution patient to avoid driving and other hazardous activities until he knows how drug affects concentration and alertness.• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, foods, and behaviors mentioned above.

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